Screw-retained vs cement-retained implant prostheses: literature review on advantages and disadvantages

Abstract

The evolution of osseointegration, combined with technological advancements and refinement in surgical techniques, has made implant-supported prostheses an effective option in modern dental practice. This article explores the advantages and disadvantages of screw-retained and cement-retained prostheses. According to the literature, cement-retained prostheses are noted for their aesthetic advantages, concealing metallic components and maintaining a continuous visual appearance, especially in highly visible areas. These prostheses also offer passive fit adjustments necessary in cases of implants with challenging angulations, promoting efficient occlusal control. On the other hand, screw-retained prostheses are valued for their ease of maintenance and repair, being easily removed for frequent adjustments. Thus, these prostheses become an ideal option for clinical scenarios requiring predictability in maintenance. However, each system presents some drawbacks, such as peri-implant complications in cement-retained prostheses due to residual cement, and aesthetic challenges in screw-retained prostheses due to exposure of metallic materials. Nevertheless, technological innovations have provided possibilities to overcome many of these current challenges. Therefore, the choice between retention systems should be personalized according to the clinical and aesthetic needs of each individual, with decisions grounded on solid evidence, always aiming to optimize clinical outcomes and patient comfort.